Malignant melanoma of the mucous membranes is rare and the prognosis is poor. The treatment of this disease has been a challenging problem for oncologists and more recently for the immunologist. We have undertaken chemotherapeutic treatment of malignant melanoma while prescribing DTIC, BCNU, and Vincristine for two patients.
Case I
The patient was a 47 year old male with complaints of right nasal hemorrhage and headache. On inspection, a painless, soft, red mass occupying the right nasal septum and the right submand ibular lymphnodes was palpable. A biopsy of the submandibular lymphnode established the diagnosis of malignant melanoma. Treatment with BLM and 5-Fu was initiated on the day of admission May, 21, 1976.
On June, 7, 1976, the treatment of combined chemotherapy with DTIC, BCNU, and Vincristine was started. The tumor regressed steadily for a short period, but gradually an enlargement of tumor on the right side of the nose was evident.
In August, 1967,
60CO irradiation, a daily treatment of 200rads was given over a 25 day period, however the tumor progressed steadily.
On September, 24, 1976, the patient was treated with bacillus Calmette-Guérin (BCG) by scarification. However the response to treatment was poor and the patient died on December, 16, 1976.
Case II
The patient was a 60 year old female with complaints of a black mass, pain, and swelling in the right gingiva.
On inspection, a soft, black, irregular mass occupied the right gingiva. A biopsy established the diagnosis of primary malignant melanoma. The bilateral submandibular lymphnodes were not palpable.
On September, 29, 1977, resection of the right maxilla was done, and the treatment with combined chemotherapy with DTIC, CCNU, and Vincristine was started post-operatively.
The patient was discharged on December, 6, 1977 and has remained well.
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